Which patients are Contasure Needleless candidates?The Needleless single incision TOT sling is used to treat stress urinary incontinence in women. The selection of patients should follow the same indications that have been used for TVT and TOT slings. Every patient with stress urinary incontinence will be suitable for the treatment with the Needleless sling (except contraindications). The results will be the same as with TVT or TOT, as shown in randomized prospective studies.

Sling procedures have some contraindications: some of those are as an example: Pregnant patients or patients suitable to be pregnant, blood coagulation disorders, compromised immune systems, renal insufficiency, urinary tract obstruction / infection.

SURGERY

How does it work?The Needleless works exactly like a TOT mesh. This is the reason the NL has in every hospital the same results as with the TOT. Normally, the urethra is supported by the pelvic floor muscles preventing involuntary urine loss. In women with SUI, the pelvic floor is weak and the tissue can´t support the urethra properly under stress.

The Needleless TOT single incision sling is placed under local anesthesia, and with a surgical forceps, to support the middle urethra. The sling is almost as long as the part of a TOT sling that remains inside the pelvic floor after surgery. It is placed through a single vaginal incision assuring a perfect anchorage at the internal obturator muscle in every patient.

In addition the system has a patented pocket positioning system that allows its adjustment and repositioning in both sides and in both directions during surgery. All this benefits combines the excellent results of a TOT system (that minislings do not maintain) with the easy and minimum invasive placement of a single incision technique.

Do I need to leave a space under the urethra?No the sling should be placed in full contact with the sub urethral tissue.

How deep should the needleless be placed?The first arm should be placed up to the middle of the mesh (blue suture) is 1 cm deeper in relation to the middle urethra. The second arm should be introduced until the middle of the mesh is centered under the urethral middle line.

OUTCOME

How many days of hospitalization are required after a Contasure Needleless surgery?The Needleless single incision sling can be placed under local anesthesia as an outpatient procedure with no hospitalization. The patient can go home the same day. The Needleless sling is also used in many patients with additional surgical procedures like hysterectomy, cystoceles, etc.. In these cases, the additional procedures requirements will dictate the hospitalization days.

What to expect after the procedure?Most women experience continence immediately after the procedure and are able to return home a few hours after surgery. When treated with Needleless system, patients will have no external skin incisions and less pain compared to a TOT procedure and easier recovery.

For approximately four to six weeks patient should avoid sexual intercourse, heavy lifting and exercise. Patient can return to other normal daily activities at doctor's discretion, often within a few days.

What does the name Needleless mean?This sling is placed with no needles making it a very safe and simple procedure, avoiding the pass of sharp Needles thought out the body as the TVT or TOT and helping the patient to recover better with less pain.